What are the ESMO guidelines for the treatment of metastatic bladder cancer?

Updated: Feb 23, 2021
  • Author: Kara N Babaian, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
  • Print
Answer

European Society for Medical Oncology (ESMO) recommendations for treatment of metastatic bladder cancer are as follows [146] :

  • Radical cystectomy with pelvic lymphadenectomy

  • Age is not a limiting factor for surgery (however, 6-month overall survival is lower in octagenarians than in patients younger than age 80)

  • Organ preservation therapy is reasonable for patients seeking an alternative to cystectomy or as a palliative treatment for those who are medically unfit for surgery

  • External beam radiotherapy may be considered as part of a multimodality bladder-preserving approach

  • Cisplatin-based neoadjuvant chemotherapy is appropriate before radical cystectomy or radiotherapy; standard regimens include GC and MVAC

For patients who cannot receive cisplatin-based chemotherapy, palliation with carboplatin-based regimen or single-agent taxane or gemcitabine is an option.

There is insufficient evidence for the routine use of adjuvant chemotherapy; high-risk patients who did not receive neoadjuvant chemotherapy may benefit from adjuvant treatment.

When the patient is unfit for cystectomy, radiotherapy can also be offered for palliation (bleeding, pain)


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!